Maternal fish oil supplementation during lactation is associated with reduced height at 13 years of age and higher blood pressure in boys only

Abstract

Dietary long-chain n-3 PUFA (n-3 LCPUFA) in infancy may have long-term effects on lifestyle disease risk. The present follow-up study investigated whether maternal fish oil (FO) supplementation during lactation affected growth and blood pressure in adolescents and whether the effects differed between boys and girls. Mother-infant pairs (n 103) completed a randomised controlled trial with FO (1·5 g/d n-3 LCPUFA) or olive oil (OO) supplements during the first 4 months of lactation; forty-seven mother-infant pairs with high fish intake were followed-up for 4 months as the reference group. We also followed-up 100 children with assessment of growth, blood pressure, diet by FFQ and physical activity by 7-d accelerometry at 13·5 (sd 0·4) years of age. Dried whole-blood fatty acid composition was analysed in a subgroup (n 49). At 13 years of age, whole-blood n-3 LCPUFA, diet, physical activity and body composition did not differ between the three groups. The children from the FO group were 3·4 (95 % CI 0·2, 6·6) cm shorter (P=0·035) than those from the OO group, and tended to have less advanced puberty (P=0·068), which explained the difference in height. There was a sex-specific effect on diastolic blood pressure (P sex×group=0·020), which was driven by a 3·9 (95 % CI 0·2, 7·5) mmHg higher diastolic blood pressure in the FO compared with the OO group among boys only (P=0·041). Our results indicate that early n-3 LCPUFA intake may reduce height in early adolescence due to a delay in pubertal maturation and increase blood pressure specifically in boys, thereby tending to counteract existing sex differences.

Effect of fish oil supplementation in pregnancy on bone, lean, and fat mass at six years: randomised clinical trial

“…One other trial supplemented with a dose similar to ours from week 30 of pregnancy and completed follow-up for 243 participants at age 19 years, finding no effect on waist circumference or BMI, which could be caused by low numbers 28. In line with our findings, one previous trial supplementing mothers with 1.5 g n-3 LCPUFA (40% eicosapentaenoic acid) during the first four months of lactation showed a significantly higher BMI and increased waist circumference in the n-3 LCPUFA supplemented children at 2.5 years,29 but no differences were seen at 7 or 13 years of age 8. We previously reported that persistent wheeze/asthma in the first years of life was reduced by approximately one third in the n-3 LCPUFA supplemented group 15.…”

“…This trial is the first to show that n-3 LCPUFA supplementation in the third trimester of pregnancy leads to a higher BMI in offspring through childhood, whereas previous trials and systematic reviews showed no effect of n-3 LCPUFA supplementation during pregnancy and/or lactation on BMI or growth development in childhood 7892122. Potential explanations for the discrepancy between our findings and previous studies include differences in the dose and type of n-3 LCPUFA supplied, the timing of the supplementation, the trial design, and the accuracy of measurements.…”

“…In humans, both observational studies on dietary intake of fish and randomised controlled trials of n-3 LCPUFA (fish oil) supplementation in pregnancy and during lactation have consistently shown higher birth weight in children born to women with higher n-3 LCPUFA intake; this is mainly explained by an increase in gestational age, but an increase in size for gestational age has not been excluded 3456. However, the long term effect on anthropometry during childhood is uncertain 78910. Mechanistic studies in rats have shown that n-3 LCPUFA supplementation both during pregnancy and in the postnatal period affects the proliferation and differentiation of pre-adipocytes, which theoretically could prevent adiposity through inhibition of fat tissue 1112.…”

Fish, Shellfish, and Children’s Health: An Assessment of Benefits, Risks, and Sustainability

“…Effects of n-3 LCPUFA in childhood on blood pressure have been less well studied and results have not been consistent, although several have suggested that supplementation may elevate blood pressure, especially for boys. This evidence comes from observational studies 92 as well as randomized trials 93 of fish oil supplementation to infants. The studies have revealed elevations in blood pressure.…”

Breast milk n-3 long-chain polyunsaturated fatty acids and blood pressure: an individual participant meta-analysis

“…0.05% for EPA and 0.18% for DHA [16]. Randomized trials have examined effects of enriched infant formula [17,18] or direct fish oil supplementation of infants [19] as well as n-3 LC PUFA supplementation of lactating mothers [20][21][22][23]. In the latter case, BP was not different at the age of 2.5 years, but BP was higher in boys at the age of 7 years and 13 years of age in those whose mothers received supplementation during lactation.…”